I don't know about you, but I've really noticed my patients accepting, and even asking for dental implants to replace their missing teeth, lately. This is undoubtedly because dental implants in general today have enjoyed a good reputation as being a successful dental treatment alternative. It is thanks to all of the many outstanding continuing education courses taught today around the country for general dentists, not to mention dental school's placing it into their curriculum, and AEGD/GPR's training general dentists right out of school. Much to the chagrin of the oral surgery, periodontal and prosthodontic residencies programs, general dentists are no longer afraid to place dental implants in the general population of patients in the USA. This leaves the specialists with the most difficult of cases, as it should be. I am not trying to say that I am an expert in placing dental implants. My oral surgeons and periodontists are still the gold standard for placing dental implants, and I will continue to refer those cases I do not feel comfortable doing myself. It is just that I find some dental implant cases relatively simple to do myself. One type of case that was routinely referred out of my office was the dental implant verses the pneumatized sinus. I can remember back in dental school when my oral surgery instructors scared all the impressionable dental students with the sinus "black hole". We were taught that one of the worst things in the world was to extract a tooth and break through the schneiderian membrane. Now we have instructors like Dr. Michael Pikos of Palm Harbor, Florida presenting to the ICOI (Vancouver) that it is not terribly bad to tear the membrane, and you can practically remove it all, and still do a sinus lift bone graft. There are some implant cases that I have identified needing a sinus lift to place an implant that could be done by lifting the floor of the sinus through the osteotomy site a few millimeters. There are several methods for doing this procedure and I feel patients accept these lifts better that the lateral window (considering the cost and scope of procedure). I will show you the one I'm using, it is called the Hatch Reamer. The name "Hatch" comes from what the bone looks like when the reamer penetrates through the sinus floor cortical bone. I went out to L.A. in 2008 to attend a hands-on workshop at a Periodontist's office called Dr. Jin Kim. He showed us how to do a sinus lift with the Hatch Reamer while using PRP mixed into the bone grafting material. Pictured above is a very simple kit of different sized "HatchReamers" and bone pluggers. This is a look from inside the sinus of a Hatch Reamer sinus lift.